The Federal Election is Over – So What’s Next?

Well it was a long night but at the end of it Mr Howard conceded defeat and Mr Rudd became the next Prime Minister of Australia. What will all this mean for the Health Sector and for e-Health in particular.

Because Mr Rudd has said he is going to appoint his own Ministry we cannot be sure who will be Health Minister, although Nicola Roxon must be a strong favourite or maybe – just possibly – Julia Gillard may decide health would be more fun than IR – she was a well informed and articulate health spokesman in the past and understood e-Health quite well.

Among the key facts are:

1. The Human Services Access Card is now officially not going to happen.

2. We are not going to have 750 hospital boards established around the country.

3. We are not going to have a sudden rash of nursing schools re-established in Hospitals from which they were removed about 30 years ago for very good reason.

What we are going to have – if ALP Policy is to be implemented some important changes in the Hospital, GP and Dental Sectors at least. From the policy speech we have:

“Hospitals

On hospitals, we have put forward a national plan to end the buck-passing between Canberra and the States.

I have a long-term plan to fix our nation’s hospitals.

I will be responsible for implementing my plan, and I state this with absolute clarity: the buck will stop with me.

Mr Howard, by contrast, has put forward no new plan.

He prefers to continue buck-passing to the States, instead of taking responsibility for fixing the system.

Australians are fed up with this tired, old game.

Australians want a long term solution for our hospitals.

They are sick and tired of short term excuses for not fixing our hospitals.

We will deliver 2,000 extra aged care beds to take the pressure off acute hospital beds.

GP SuperClinics around Australia to take the pressure of accident and emergency departments.

A national fund to eliminate elective surgery waiting lists beyond clinically acceptable times.

A massive national investment in the war against cancer.

And 10 years after Mr Howard abolished it, we will re-establish a Commonwealth Public Dental Program.”

More details of Labor’s plans to address the Commonwealth State divide are found here.

The full ALP Policy Platform can be found here – Chapter 10 is the important bit for this blog.

The two relevant sections for e-Health are as follows:

ALP National Platform and Constitution 2007

Tele-health

47. Labor will significantly expand access and improve decision making processes for patients and health professionals through the encouragement of new technologies. The potential applications for tele-health in rural areas are significant, particularly as a means of reducing the level of professional isolation experienced by rural and remote health workers. Labor will provide resources to significantly expand tele-health services. These new technologies will be used to complement the delivery of face-to-face services in rural areas rather than replace them.

And

Harnessing New Technology and Managing Patient Information

“67. Labor sees major opportunities for new technology to make health services more effective, more accessible and more consumer friendly. Technological change needs to be carefully managed with close attention to the social and ethical implications and the need for privacy for personal health records. Labor will ensure that commercial interests do not subvert intended health outcomes and that decisions are made on the basis of clinical and cost effectiveness determined by the best available research evidence.

68. Labor will, in collaboration with State and Territory governments, build information technology and communication infrastructure and systems that improve the decisions made by consumers, clinicians and health service managers about care, service delivery and policy. The purpose of this investment will be to:

• build accessible knowledge bases from quality data systems, libraries of research evidence and the experience of consumers and professionals;

• enhance online communication between consumers and professionals, and primary and acute care settings, regardless of location, to improve health outcomes and service quality; and

• create data management systems that monitor population health and the safety, quality and efficiency of health services.

69. Labor will ensure that appropriate training is undertaken by health professionals to develop and maintain the skills necessary to use these knowledge bases, health records and communication systems.

70. Labor believes the development and implementation of health knowledge management systems that include electronic health records and decision support systems for evidence based practice are central to improving the safety and quality of health services. However, these new tools cannot be widely used until satisfactory arrangements are in place to protect security and privacy.

71. Labor will ensure every Australian has a personal electronic health record that is privacy protected. Labor will develop a strong privacy regime built around a unique patient identifier based on the Medicare card. Legislation will prohibit this number being used for any other purpose and access will depend on authorisation from both the patient and the doctor. A range of other safeguards will be incorporated in legislation, which will be developed after a public inquiry into all the issues.

72. It is critical that health providers can communicate effectively with each other while maintaining patient confidentiality. Labor will provide leadership in the development of national, secure health data standards and will establish a common framework for health record systems. The delay in establishing this infrastructure is inhibiting the delivery of quality health services in Australia and contributing to unnecessary adverse events.

Specifically Labor will ensure:

• the use of tele-health to give rural clinicians direct access to city based specialists and the resources of major teaching hospitals;

• the use of secure electronic networks to give clinicians and pharmacists access to high quality drug information sources; and

• the use of electronic prescriptions to speed up and reduce errors in communications between clinicians and pharmacists.

73. Labor will give Medicare Australia greater powers to analyse data to examine variations in practices, to enable the promotion of professional practice based on the best available evidence from research. Clinicians will be supported in their evidence-based practice through the development of appropriate, accessible clinical guidelines and pathways of care.”

All this is music to those who see further development in e-health as fundamental to better health care safety, efficiency and quality. It must all be followed up and implemented!

What is missing from the policy platform are three things. These also need to happen in my view:

1. There is not a section that makes the link between effective computerisation of General Practice and delivery of consistent quality GP care – which is what is needed to actually have more preventive care undertaken. Intelligent advanced decision support for GPs is a major way to make sure all relevant interventions are scheduled, undertaken and followed up.

An extra sentence or two in this area would have made me a much happy camper – knowing the link between e-health deployment and better preventive care was fully appreciated at the top!

2. There is no commitment to undertake development of the National E-Health Plan most realise is needed urgently and which has been superbly documented by the Health Informatics Society of Australia.

3. There needs to be the onset of openness and transparency – as Labor has proposed – with the release of and actioning of the Boston Consulting Group review of NEHTA.

That is enough to put on the new Minister’s Agenda for the first 100 days of the new Government.

We can hope at last, so let’s get on with it! I hope I will not be disappointed.

David.

Weekly News Bits will be posted tomorrow.

D.